Helmet CPAP treatment in patients with COVID-19 pneumonia: a multicentre cohort study
Stefano Aliberti, Dejan Radovanovic, Filippo Billi, Giovanni Sotgiu, Matteo Costanzo, Tommaso Pilocane, Laura Saderi, Andrea Gramegna, A. Rovellini, Luca Perotto, Valter Monzani, Pierachille Santus, Francesco Blasi
Abstract
Patients with coronavirus disease 2019 (COVID-19) pneumonia can develop hypoxaemic acute respiratory failure (hARF) with the need for positive end-expiratory pressure (PEEP). The administration of continuous positive airway pressure (CPAP) through a helmet improves oxygenation and avoids intubation [1, 2]. A European consensus document suggests that helmet CPAP should be the first therapeutic choice for hARF caused by COVID-19 pneumonia, mainly for minimising aerosol generation [3–5]. However, recommendations are based on experts' opinion and consider only evidence obtained in critically ill COVID-19 patients [3]. The Surviving Sepsis Campaign does not recommend the administration of CPAP for the initial management of severe COVID-19 [6]. Helmet CPAP treatment fails in up to 44% of patients with moderate-to-severe hypoxaemic acute respiratory failure due to COVID-19 pneumonia <https://bit.ly/3g7FAB8> The authors would like to acknowledge the support of all the pulmonologists, respiratory fellows, nurses and respiratory physiotherapists of the COVID-19 HDUs of the Policlinico and Luigi Sacco Hospitals in Milan, Italy.